Medical Needs of 
 Chinese Women and Children 
 
Bound-footed woman waiting for treatment 
 
EXPERIENCES OF A DOCTOR IN NORTH CHINA 
 
 By Emma Tucker , M.D., Tehsien 
 
 S TEAMING into the first Asiatic port touched on the 
 way to the great land of China some sixteen years ago, 
 two young medical missionaries, fresh from training 
 in America’s colleges and hospitals, and eager with a humble but 
 sacred longing to give to their less fortunate brothers and sisters 
 something of all they had received, were somewhat surprised to 
 be arraigned, with all other passengers, on the deck of the ocean- 
 liner to pass a medical inspection at the hands of Oriental phy- 
 sicians. 
 
 This was in Yokohama, five or six officious-looking, spectacle- 
 wearing Japanese physicians boarding the vessel to conduct the 
 examination to see if these Occidentals, medical and non-medi- 
 cal, were free from contagious or other undesirable diseases. If 
 so, they would be permitted to land. The same program was 
 carried out in the ports of Kobe and Nagasaki. Then, approach- 
 ing China’s great port of Shanghai, in their innocence the phy- 
 sicians inquired, “Do we have to pass medical inspection at the 
 hands of the Chinese physicians here?” 
 
 “No,” was the reply of the ship’s officer. “China is the home 
 of Asiatic cholera, plague, dysentery, and the like. Here these 
 and similar diseases thrive. There will be no medical inspection 
 of us to enter this land.” 
 
 Too true was this which he uttered. No less true is that 
 which has been said, “China was opened at the point of the 
 lancet” in the hands of Dr. Peter Parker. Tens of years ago 
 the missionary learned that the medical arm of the missionary 
 service was the entering wedge for the Gospel into the hearts of 
 the Chinese. Through this practical demonstration of Chris- 
 tian love and sympathy, the matter-of-fact Chinese learned of a 
 Love that could move men to give their lives and means for the 
 good of others, even to those of an alien race and unknown peo- 
 ple. This, until most recent years, was our greatest point of 
 contact with the Chinese. No wonder that the late Dr. Henry 
 D. Porter said that more than fifty per cent of a certain well- 
 
 3 
 
known region in North China came to Christ because of having 
 learned of Him through the work of the hospital of that region! 
 
 Then, the need! A whole nation without surgery! A whole 
 nation not knowing the use of soap! A whole nation where eye 
 troubles abound! A whole nation not understanding the causes 
 and effects of contagious diseases! A whole nation with a pop- 
 ulation of a quarter of the human race, but bound by the fetters 
 of custom, purposely crippling one-half its number by binding 
 the feet of its women, thus making them an easy prey to every 
 passing disease! In fact, a whole nation with only the begin- 
 nings of modern medical science! 
 
 Upon the women of such a land do the physical ills that human 
 beings are heir to, fall particularly hard. Those precious eyes! 
 Every girl must marry. There is no future for the daughter of 
 China outside of the home of her husband’s family. She can- 
 not inherit land or chattels from her father. Yet, if she can- 
 not sew, cannot do the endless stitching necessary to cover the 
 bodies of the numerous members of the family, including hun- 
 dreds of pairs of shoes, made of cloth, soles and all, — each pair to 
 be renewed every month — “Who wants such a daughter-in-law?” 
 All those shoes for women and girls, covering wilfully deformed 
 feet, must be beautifully embroidered and exquisitely stitched. 
 Who can do all this but the young women? O, the pity of it all! 
 
 See the many children blind through neglect, their parents 
 knowing not the first principles of cleanliness for eyes! See the 
 numbers of women whose eye troubles are legion, — victims of the 
 green un-dried fuel of grass and leaves, the acrid smoke of which, 
 irritating the eyes, makes a soil pregnant with possibilities for 
 the planting of trachoma (“granulated lids”)! Then comes the 
 aftermath of that disease, eyelids turned in; the lashes scratching 
 delicate eye membranes — no relief day or night; inflammation; 
 clouding of the eyes; blindness. See the literal hundreds that 
 come to every hospital yearly, largely women and girls, with 
 eyes like these — eyes that are never wiped, save on the family 
 towel, year in and year out, washed (when it is washed!) without 
 soap or boiling! 
 
 The tragedy of the eyes of China! Suicide, or a life of beg- 
 gary, — these await the sightless. But the hospitals minister 
 to these, and grateful hearts turn to the Giver of Light, seeing 
 with their “heart-eyes” as well as their physical ones. 
 
 4 
 
Early readers of this magazine doubtless remember the story 
 of Mrs. Ma, the efficient hospital matron at Pangchwang for 
 almost a score of years. In middle life she became blind from 
 cataracts. A widow with several children, this condition re- 
 duced her to beggary. When asking one day for bread she was 
 told, 
 
 “Why not go to the Pangchwang hospital and receive your 
 sight?” 
 
 “But I have no money.” 
 
 “They do not ask money. They do these wonderful cures 
 because actuated by motives of love.” 
 
 She came, the journey requiring a whole week — being led by 
 the hand of her youngest son, called because born in the midst 
 of such poverty, “Wu Yin, No Silver.” They begged for food 
 the whole way. At the hands of the surgeon she received her 
 sight. Her “heart eyes,” too, were opened, and she saw Him. 
 She heard His call. She applied herself, when past the age of 
 fifty, to the study of the Scriptures. Her mind was an unusually 
 clear and concise one, level-headedness going hand-in-hand with 
 pity and mercy in all her dealings with her own people. 
 
 “No Silver” grew up in the mission schools. He graduated 
 with honors from college, then studied medicine, and is a Chris- 
 tian doctor in North China. With his educated Christian wife 
 they maintain a home noted especially for cleanliness and the 
 careful training and nurture of the four beautiful children God 
 has given them. Picked from a rubbish heap and transformed 
 into vessels meet for service. 
 
 Motherhood! Again a tragedy! If no sons, “Please give me 
 that which will make it possible to bear sons. I have no stand- 
 ing in my family because I have no male posterity. Daily I am 
 made to feel this by nagging persecutions. There will be no 
 one to inherit our few belongings. There is no one to carry 
 on the family name. There will be no one to do honor to us at 
 our graves, and minister to our spirits when we are dead. O, 
 make it possible for me to bear sons! Death is preferable to life 
 without sons.” How often does the woman physician hear this 
 despairing cry! 
 
 Last year there came to the Porter Hospital for Women at 
 Tehsien an eager summons to the highest official y amen in the 
 city, — that of the General in charge of all troops of north-east 
 
 5 
 
China from Shantung to Manchuria. The suppliant was a sec- 
 ondary wife, the mother of four daughters and one son. “Slaves” 
 she scornfully termed her daughters, for, only as the mother of 
 sons could she hope to win and hold the favor of her husband. 
 The invitation came to the woman physician, but with the added 
 request that if the man physician would accompany her, they 
 would be doubly grateful. The petted son, aged three, dressed 
 handsomely in brocaded satins, lay shaken with convulsions. 
 
 They were urged to come to the hospital for final diagnosis, 
 but without much hope of cure. Every form of treatment known 
 to native quackery and prescription had been tried. The mother 
 told that, in addition, she had made a vow in “The Medicine 
 King Temple” (Buddhist) near by, that if the gods would heal 
 her son, she would pay tens of thousands of strings of Chinese 
 “cash,” to the temple. Finally they listened to advice and the 
 child was brought, carried in the arms of its devoted father. 
 He rode in a sedan chair, borne by men, that the child be not 
 jolted. 
 
 Father, mother, a retinue of servants, yamen runners, and 
 the like, took up their abode in the hospital. Men in high posi- 
 tion came daily to confer with the General in regard to affairs of 
 state. For six days there was trembling, fear and hope, and 
 then the little life went out, a victim of tubercular meningitis. 
 They had come too late. 
 
 The mother in her wild grief could hardly be comforted. Yet 
 in this hour she thought to bring happiness to the children of the 
 “foreign” physicians who had labored, in love, to save her child. 
 She went to their home and insisted on “sweets” being purchased 
 for them, she providing the money. The lovely little boy was 
 dressed in all the regalia and elegant robes of a high official’s 
 son, to be laid away in his cold home. The father asked eagerly, 
 “Do you know that innocent children will be happy after death?” 
 And we had comforting messages for him, — of the God of hope, 
 of everlasting life. All this was more real to him on account of 
 the ministry which the child had received, — a ministry that ex- 
 tended to the entire family on the part of the full hospital staff. 
 
 There come other imperative, pleading summons. The wom- 
 an physician is wanted. Native midwives, sometimes old and 
 blind, sometimes strong and cruel, have attempted all that lies 
 in their power to bring relief. An expectant mother lies exhaust- 
 
 6 
 
ed and near death after three days of terrible suffering. The 
 maltreatment to mother and child is unspeakable. A little 
 arm lies detached. A meat hook near bears evidence of the use 
 to which it has been put. 
 
 We plead that the patient be carried, — on a crude native bed, 
 “borne of four,” — to the hospital. We wish to exchange the 
 room with its paper windows, earthen floor, and mud-brick bed, 
 or k’ang, from which every movement sends up a cloud of dust, 
 for the sweet cleanliness of the hospital’s white walls, appro- 
 priate equipment, and kindly ministry of nurses and others. 
 They listen and obey, and the gratitude of the entire family is 
 won, because the mother’s life, at least, is spared. When both 
 lives are given back to them, their joy knows no bounds, es- 
 pecially if one is that of a son. 
 
 Tuberculosis! Its ravages are ever in evidence. It spares 
 not at all this race, so almost universally underfed. The women 
 and girls with restricted lives and movements, by reason of 
 bound feet, living so little out of doors, but sitting cross-legged 
 in sunless rooms, fall easily a prey. They come to the hospital 
 with tubercular affections of any of the two hundred bones of 
 the body. With tubercular glands, tubercular lungs, tubercular 
 spines, tubercular meninges, but with tubercular bones especially, 
 they come. Their number is legion. The compressed bones 
 of the feet are particularly liable to this affection. The sugges- 
 
 Nurse and patients at Tehsien 
 
 7 
 
tion to amputate a foot or a hand on account of this affliction 
 meets no happy response. 
 
 “I’d rather she’d die than live with only one hand,” says a 
 heartless husband to the pleading physician, even though the 
 wretched wife sits by, hearing. 
 
 Another husband complains, — or perhaps it’s a father referring 
 to his daughter — “She isn’t dead, because she still eats. She 
 isn’t alive because she can’t work.” 
 
 With no help for the physical ills, — wounds undressed winter 
 and summer, the infection ever spreading and deepening — and 
 with the family begrudging every mouthful of food eaten by such 
 an unprofitable member of it, a too often merciful — to them — 
 relief is found in suicide. How much of happiness comes to that 
 family when the hospital can restore the worse than useless 
 member of it to its proper place in the home! 
 
 One of the brightest sides of the medical work among the 
 women of China is the life-call that has come to a select number 
 of these same educated Christian young women to prepare them- 
 selves to be physicians and nurses among their needy own. Both 
 are new callings in China, but nursing, especially, is a very new 
 profession in a very old land. Nowhere, nor at any time, were 
 these two avenues of compassion more appealing. Here can 
 America’s women multiply their lives in mercy, in skill, in ten- 
 derness, and in love, “a thousand fold.” 
 
 8 
 
FIGHTING DISEASE IN FOOCHOW 
 
 By Lora G. Dyer, M.D., Foochow City* 
 
 T HE difficulties in medical work for women and children 
 in China are in the main the same as in any other part of 
 the non-Christian world, as, for example, poverty, 
 ignorance and prejudice. But the effects are worked out with 
 local colorings. In Foochow, for instance, and the surrounding 
 plain, an area of about fifty square miles, there are many women 
 whose feet are not bound. The economic pressure brings it 
 about that these women share with the men the field work and 
 the carrying of loads. This brings to our clinics women with 
 chronic leg ulcers badly aggravated by hours of wading knee- 
 deep in the rice fields, and women load- 
 
 One ambitious young girl wanted to 
 
 “read books” anti undertook to earn the 
 
 necessarv money bv carrying loads. At the 
 
 end of two years her heart gaveout and she 
 
 could neither carry loads nor enter school. 
 
 More rarely the eco- wKS nomic or social con- 
 ditions work to mark- ed advantage, as seen 
 
 among the boat people ■ 1 y who until recently 
 
 were not allowed to \. j/ live on land, and who, 
 constantly living on semi-open boats, are 
 
 noticeably robust Dt. Dyer and clean. 
 
 Custom and fear conspire with poverty to bring about much 
 pernicious crowding both in the country and the city. Parents 
 and small children may all sleep in one bed, some at the head and 
 some at the foot, usually without undressing, in a room closed up 
 as tightly as the poorly built partitions will allow. Children, and 
 even adults, often sleep with the head under the bedcovers. 
 Poverty, of course, also means underfeeding, which is very wide- 
 spread in China, making the fight against tuberculosis doubly 
 hard, and lowering resistance against all diseases. 
 
 *Note. Dr. Dyer's home was in Plainfield, Mass. After graduating from Smith 
 College in 190;}, she received her medical degree from the Woman’s Medical 
 College, Philadelphia. After serving a year as interne at the New England Hos- 
 pital for Women and Children in Boston she joined the Foochow Mission in 1916. 
 
 9 
 
T HE building in which Dr. Lora Dver has begun 
 her hospital work. It is situated in the suburbs 
 ot Foochow, in a district known as Gek Siong Sang. 
 The building is mission property, intended for evan- 
 gelistic work, but temporarily borrowed and fitted up 
 for medical work until conditions are favorable for the 
 erection of the new hospital for which funds are in 
 hand. Besides providing ample room tor a dispensary, 
 this building has accommodations for a good number 
 of in-patients. 
 
 io 
 
The Chinese loyalty to their own ways and customs and their 
 distrust of things foreign is a frequent barricade in the doctor’s 
 path. The extension of confidence is mainly a word-of-mouth 
 process. A few days ago a man came leading in his small son 
 saying that he had the same illness as the table boy from our 
 neighboring compound (an abscess of the hand) which had been 
 quickly healed under our treatment. This boy’s home was at 
 least five miles away at the foot of the mountains, but the table- 
 boy’s home was in the same village. A student returning home 
 relates the successful treatment of some case in school, a family 
 escapes plague through inoculation, a case of diphtheria is cured 
 by antitoxin, a bad accident is satisfactorily healed at the mission 
 hospital and the defense for western medicine is passed on to the 
 neighbors and the neighbor’s neighbors. 
 
 The system of medicine to which the Chinese usually pin their 
 faith is mostly quackery. The qualification of the native doctor 
 is the ability to read and translate the classical books on medi- 
 cine, written hundreds of years ago, and to impress the patient. 
 A knowledge of anatomy or physiology is superfluous. Detailed 
 descriptions of their drugs and treatments can be found readily 
 in books on China. And the treatments mentioned are not 
 obsolete eith'er. I have seen three children this year with hands 
 and feet badly swollen due to the use of hot needles. One wom- 
 an came in with a toe in such condition that it had to be ampu- 
 tated owing to the burning with moxa as a part of the native 
 doctor’s treatment. Yet Foochow is a port city. 
 
 The ignorance of the people is a tremendous factor in in- 
 creasing the death rate. In the epidemic of pneumonic plague 
 in North China last year a Chinese official complained that 
 “the difficulties encountered by the Chinese Plague Preventive 
 Service in battling with plague epidemics were mainly owing to 
 ignorance on the part of the people of modern medical methods, 
 due primarily to the complete absence of missionary and other 
 medical institutions in the district affected by the epidemic.” 
 
 A wide-spread, long-continued campaign in sanitation and 
 hygiene in Fukien province, or any province for that matter, 
 would undoubtedly save more lives than are now being healed 
 in our clinics. The diseases that harass China the most severely 
 are all preventable, — tuberculosis, syphilis, gonorrhoea, tracho- 
 ma, malaria, dysentery, plague, smallpox, leprosy, typhoid, 
 
measles (more feared than smallpox), — preventable if only the 
 people could be educated into willingness to co-operate for the 
 benefit of their neighbors as well as for themselves. Our mis- 
 sion schools have made a good though limited beginning, — the 
 cleanliness of the homes of the students, is noticeable. The 
 physical examinations of the Ponasang girls this year showed 
 marked improvement in general health, and noticeably in the 
 ability to breathe deeply. 
 
 There is special need of teaching in the care and feeding of 
 children and in dietary matters in general. Probably 99% of 
 the babies in our province are breast-fed but the supplementary 
 diet that is offered them as early as they will accept it is often 
 fatal. Raw, unripe fruit, two kinds of vegetables about half 
 way between a radish and a cocoanut, though more juicy, also 
 eaten raw, cakes of many kinds, some of them about as digestible 
 as uncooked piecrust, anything that the child cries for, is given 
 and then a large quantity of steamed potatoes is given to cure 
 the diarrhoea caused by “the weather.” The adult diet of rice, 
 excellently cooked, is very wholesome, but the number of dys- 
 pepsia cases in our clinics is disproportionately large, apparently 
 due to the universal habit of swallow- 
 ing the rice without making any sort of 
 attempt at mastication. 
 
 Next to the need for education in 
 hygiene is the crying need for better 
 
 A Chinese Nurse in charge ajter the Surgeon has gone 
 
 12 
 
midwifery. Over and over the foreign doctor is called in 
 to undo the damage after the native midwife has been doing 
 her worst at the job for two or three days. Septicemia 
 is a very common sequence. A year ago when I visited our 
 girls’ school in Inghok a man from a nearby village came asking 
 me to see his wife, who was a relative of one of the school girls. 
 The baby was more than a month old but his wife was still 
 “unable to walk and short of breath.” 
 
 I went to his house and he led me to the bedroom, a small 
 room with a tamped earth floor, without windows, and so dark 
 that when I stepped through the doorway I could not see where 
 the patient was. A candle showed a young woman sitting on 
 the edge of the bed with her forehead resting on a pile of dirty 
 bedding placed in a chair opposite her. She could not breathe 
 lying on her back and a bedsore on either hip denied her any 
 position but this. Her bare feet were terribly swollen and as 
 cold as a stone; there was still a slight fever and her heart was 
 simply galloping. There was no woman to do anything for her 
 and her husband and father-in-law were very clumsy. When 
 she died a week later I could not feel that death was her enemy. 
 
 In all Fukien provinces there is no tuberculosis sanitorium. 
 In all China I know of but two hospitals for the care of the in- 
 sane, one large institution in Canton and a smaller one in Soo- 
 chow. In the other cities the insane are tied to their beds, or 
 locked in bare rooms, or roam the streets. A few months ago 
 I was called to see a girl of about sixteen who had suddenly lost 
 her mental balance, refused to eat and babbled without sense or 
 sometimes raved excitedly. Her parents dared not leave her 
 alone for a moment. All the idols who could possibly be in- 
 terested had been consulted and the parents themselves were 
 nearly crazy. It is very probable that if this girl’s case could 
 have been carefully studied and correctly treated in a hospital 
 her balance could have been restored promptly, but an insane 
 patient in a general hospital drives all the other patients 
 home. 
 
 A lad in his teens, recently brought to the clinic by his mother, 
 made such a commotion shouting and weeping and spitting every- 
 where that he had to be taken outdoors until his turn came. 
 Three days later, following heroic treatment with Epsom salts 
 in his own home, the boy returned alone, so absolutely sane in 
 
 13 
 
appearance that I could not believe he was the same patient. 
 
 The lepers receive rather more public attention and every 
 large city has its leper village without the gate, and many lepers 
 within the gate, as well. Incipient cases often come to us for 
 diagnosis. The first patient that came to the dispensary which 
 was opened last fall in connection with one of our churches, was 
 a girl of seventeen with a single small lesion of leprosy on her 
 cheek. Last week a field-woman came asking for medicine to 
 cure the smooth purple anaesthetic spot on her foot. Advanced 
 cases may be seen daily in the streets. 
 
 The medical work for women in Foochow, under the Woman’s 
 Board of Missions, was limited during 1918 to daily dispensary 
 work only. This year, 1919, has marked the re-opening of the 
 hospital for in-patients, as well as out-patients, in temporary 
 quarters, after a lapse of about ten years. It has a capacity of 
 about twenty-five beds. In the two months since opening 
 about 400 treatments have been given to out-patients, in addi- 
 tion to 263 days residence in hospital. The work is in charge 
 of one physician with a Chinese locally trained nurse. The 
 absence of a foreign-trained nurse means that there is no training 
 school for nurses in connection with the work. 
 
 U 
 
1919 
 
 Woman’s Board of Missions 
 14 BEACON STREET 
 BOSTON